[Psychological condition of children from pregnancies after assisted reproduction in the third year of life]. / Psychický stav detí z tehotenství po asistované reprodukci ve tretím roce zivota.

OBJECTIVE: To analyse psychological development of children born after assisted reproductive technology. DESIGN: Psychological analysis of the child's development related to the technology of assisted reproduction, length of pregnancy and multiple birth was performed and compared with the control group. SETTING: Institute for the Care of Mother and Child, Prague. METHODS: Out of the total number of 123 children born after assisted reproductive technology during the 1st half of the year 1998 in the Center ISCARE IVF, psychological development was evaluated in 109 children (88.6%). Ninety four children from this sample were assessed using mental, motor and behavior scales of the Bayley Scales of Infant Development II. RESULTS: Mental and motor development of infants born after intracytoplasmatic injection (ICSI) and after in-vitro-fertilisation (IVF) was not significantly different. Fullterm singletons born after assisted reproductive technology did not differ from control fullterm children. There was a developmental delay in both fullterm and preterm children from multiple pregnancies in comparison to control children. No child had serious impairment of psychic functions (developmental index <50). There were no significant differences in behavior records between children born after assisted reproductive technology and control children, but some parents had problems in educational care of their children born after assisted reproductive technology. CONCLUSION: From children born after assisted reproductive technology, those from multiple pregnancies may be at risk for later psychological development. The occurrence of educational problems in assisted reproductive families indicates a need of accessible professional care in this field.

[Effect of early nutrition on growth parameters and psychomotor development of children of very low birth weight]. / Vliv casné výzivy na rustové parametry a psychomotorický vývoj u detí s velmi nízkou porodní hmotností.

OBJECTIVE: The aim of the study was to evaluate influence of early nutrition on growth parameters and psychomotor development of children with very low birth weight (VLBW). DESIGN: A prospective clinical study. SETTING: Institute for Care of Mother and Child, Prague. METHODS: Thirty nine children of birth weight 1,000-1,499 were followed up to one year of their corrected age in a prospective study. The group was divided in two groups according to type of nutrition: 17 children (group A) were fed with milk of own mother - "preterm milk", 22 children (group B) were orally fed with mature milk from the Bank of mother milk - "term milk", which was fortified with BMF preparation (Nutricia, Netherlands). Both groups were comparable in basic anthropometric parameters (weight, lenght, circumference of head and thotax) and in psychosocial characteristics of their mothers. Growths parameters were monitored in weekly intervals for approximatelly eight weeks. In the period between 11th and 15th month of corrected age, the children were evaluated by a clinical psychologist on a blind basis in mental a motor development by using Bayley Scales of Infant Development (BSID-II). Statistical analysis was performed by chi-square test and t-test. RESULTS: No statistically significant differences between the two groups in evaluating the growth parameters were observed. The psychological examination demonstrated statistically significant differences in the motor development. The psychomotor developmental index (PVI) proved to be 84.4 +/- 14.6 in the group A and 94.3 +/- 12.5 in the group B (t-test = 2.28, p<0.05). There was not any statistically significent difference in metal development between the two groups. The mean mentel developmental index (MVI) was 98.2 +/- 10.2 in the A group and 101.0 +/- 13.3 in the group B. CONCLUSION: Result of the study indicate favorable effect of fortification of breast milk in VLBW newborns, especially in view of the observed favorable influence of fortfication on motor development of the children.

EEG spectrum as information carrier.

Spontaneous and provoked changes of vigilance and consciousness are determined by TCS (thalamocortical system) activity. This is relatively easy to monitor using EEG, which is a complex curve but open to analysis, e.g., by means of FFT (fast Fourier transformation). Twenty six persons (six normal controls, twelve epileptics, eight dements) had EEG recorded during rest, reaction to sound, and perception to simple tones or chords from Smetana's symphonic poem Vysehrad. The length of reaction time was found dependent on FFT changes: the longer the time, the higher are the delta and the lower the alpha activities in the EEG spectrum. However, with alpha increasing during relaxation, the reaction time grew longer regardless of whether delta had increased due to hyperventilation, sleep or subclinical epileptic discharges. During the perception of tones, FFT showed changes in the alpha and delta bands different from those during the perception of chords, and different again during relaxation, and that in both normal controls and epileptics. The demented persons revealed no discernible FFT differences in the perception of either tones or chords, the only differences were found in the resting sections of the spectrum. One and the same stimulus produced a stereotype FFT response, i.e., different stimuli elicited different FFT response in healthy and epileptic persons. The dements responded to identical stimuli differently, and had stereotype FFT response elicited by the same stimuli. The results suggest that FFT can represent the information content of the EEG curve and, indirectly, also that of micro-EEG as it reverberates between the thalamus and the cortex in the form of neuronal activity impulsations. This interneuronal impulsation coding is disordered in dements with atrophy of the cortex; it is marked, on the one hand, by increased variability in the perception of identical stimuli, and, on the other hand, by impaired differentiation, and, consequently, by increasingly stereotype responses to different stimuli.